67例儿童急性白血病流式细胞术免疫分型的研究

目的探讨儿童急性白血病流式细胞术（flow cytometry）免疫分型的特点。方法选择67例儿童急性白血病，采用CD45／SSC双参数散点图设门法流式细胞术进行急性白血病免疫表型检测，分析儿童急性白血病细胞的抗原表达规律。结果①FAB分型与免疫分型相符率为92．5％（62／67）。②B细胞系列急性淋巴细胞白血病（B-ALL）中CDl9敏感性最高，HLA-DR、cCD79a特异性强。T细胞系列急性淋巴细胞白血病（T-ALL）中cCD3、CD7敏感性最高，cCD3特异性强。③急性髓细胞自血病（AML）中CD117、CDl3、CD33敏感性高，CDll7、cMPO的髓系特异性强。④急性淋巴细胞白血病（ALL）中伴髓系抗原表达（My^＋-ALL）占50．0％，主要表达的髓系抗原为CD33、CDl3。AML中伴淋系抗原表达（Ly^＋-AML）占35．0％，主要表达的淋系抗原为CD7。结论①免疫学分型弥补了FAB分型的不足，更能反映白血病细胞的异质性，提高了诊断的准确性。②儿童降ALL最具有诊断价值的抗原是CDl9、HLA-DR、cCD79a，T-ALL最具有诊断价值的抗原是cCD3、CD7。My^＋-ALL主要表达的髓系抗原为CD33、CDl3。③儿童AML最具有诊断价值的抗原为CDll7、CDl3、CD33，而CDll7的髓系特异性优于CDl3、CD33，是鉴别ALL、AML的重要标志，Ly^＋-AML主要表达的淋系抗原为CD7。

Investigation of Immunophenotype in 67 Cases of Children's Acute Leukemia Via Flow Cytometry

Objective To explore immunophenotyping specificities in children＇s acute leucocy-themia via flow cytometry. Methods Flow cytometry and CD45/Side scatter（SSC） gating were used to have immunophenotyping of children＇s acute leucocythemia tested and to analyze antigenic expressions in 67 cases of children＇s acute leukemia. Results ①the rate of conformity reached 92.5% between FAB and immunophenotype. ②in B-ALL CD19 was the most susceptible, and HLA-DR as well as cCD79a were with intense specificity, in T-ALL cCD3 and CD7 were most sensitive, and cCD3 was intense in specificity. ③in AML CDl17. CD13. CD33 were high sensitivity and CD117.cMPO potent specificity.④My^＋ -ALL made up 50.0% of ALL, whose primary expressions were such myeloid antigens as CD13 and CD33. Ly^＋ -AML constituted 35.0% of AML, chiefly expressive of CD7. Conclusion ①Compared with FAB,immunophenotype can reflect the heterogeneity of leukemia cells more distinctly and consequently enhance the exactness of diagnosis.②Diagnostically, CD19, HLA-DR and cCD79a are the most valuable antigens in B-ALL, whereas cCD3,CD7 is most essential in T-ALL. Besides,CD13 and CD33 are predominantly expressive myeloid antigens of My^＋ -ALL. ③CDll7.CD13 and CD33 are diagnostically the most valuable antigens in AML, while CDl17, whose myeloid specificity is superior to CD13 and CD33,is a crucial indicator of ALL and AML. Besides, CD7 is primarily expressive antigen of Ly^＋ -AML.